MILK and dairy products - Food and Agriculture Organization

1 milk and dairy products in human nutrition Technical Editors Ellen Muehlhoff Senior Officer Nutrition Division Anthony Bennett Livestock Industry Officer Rural Infrastructure and Agro-Industries Division Deirdre McMahon Consultant Nutrition Division milk and dairy products in human nutrition FOOD AND Agriculture Organization OF THE UNITED NATIONS Rome, 2013. Cover photo credits front: EADD/Neil Thomas (top), FAO/A. Conti (bottom). back: ILRI/Apollo Habtamu (top), courtesy of Heifer International (mid), World Bank/Ray Witlin (bottom). The designations employed and the presentation of material in this information product do not imply the expression of any opinion whatsoever on the part of the Food and Agriculture Organization of the United Nations (FAO) concerning the legal or development status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries.

2 The mention of specific companies or products of manufacturers, whether or not these have been patented, does not imply that these have been endorsed or recommended by FAO in preference to others of a similar nature that are not mentioned. The views expressed in this information product are those of the author(s) and do not necessarily reflect the views or policies of FAO. ISBN 978-92-5-107863-1 (print). E-ISBN 978-92-5-107864-8 (PDF). FAO 2013. FAO encourages the use, reproduction and dissemination of material in this information product . Except where otherwise indicated, material may be copied, downloaded and printed for private study, research and teaching purposes, or for use in non-commercial products or services, provided that appropriate acknowledgement of FAO as the source and copyright holder is given and that FAO's endorsement of users' views, products or services is not implied in any way.

3 All requests for translation and adaptation rights, and for resale and other commercial use rights should be made via request or addressed to FAO information products are available on the FAO website ( publications) and can be purchased through iii Contents Preface xii Foreword xiii Acknowledgements xv Abbreviations and acronyms xviii Contributors xxi Chapter 1. Introduction 1. Nutrition and health 1. Progress in nutrition outcomes 1. Undernourishment 1. Childhood undernutrition 2. Micronutrient malnutrition 2. The double burden of malnutrition 3. Linking Agriculture and nutrition 4.

4 The role of milk and dairy products 5. dairy programmes affecting nutrition 7. Linking dairy Agriculture and nutrition 7. References 9. Chapter 2. milk availability: Current production and demand and medium-term outlook 11. Abstract 11. Trends in food consumption patterns the role of livestock and dairy products 11. Drivers of increasing consumption of milk and livestock products 20. Trends in milk production patterns 22. Effects of technological changes on milk production and processing 26. Trends in international trade in livestock products 28. Future trends in production and consumption of dairy products 30.

5 Iv Emerging issues and challenges 32. Impact on the environment 33. Impacts on animal and human health 34. Challenges for smallholder production and poverty alleviation 34. Conclusion 35. Key messages 35. References 37. Chapter 3. milk and dairy product composition 41. Abstract 41. Introduction 41. milk composition 43. The role of milk as a source of macronutrients 43. Composition of milks consumed by humans 44. Factors affecting milk composition 59. Nutritional value of milk from various species 60. Treated liquid milks and dairy products 64. milk classifications 66. Heat treatments and microbiocidal measures 70.

6 Fermented milk products 74. Cheese 78. Butter and ghee 84. Cream 85. Whey products 86. Casein 88. milk products from milk from underutilized species 88. Key messages 89. Issues and challenges 90. References 90. Chapter 4. milk and dairy products as part of the diet 103. Abstract 103. Introduction 104. Limitations of studies reviewed 105. Interpreting study results 106. milk as a source of macro- and micronutrients 106. Dietary dairy in growth and development 111. Studies on the effect of milk and dairy products on linear growth in undernourished or socio-economically underprivileged children 113.

7 The role of milk and dairy products in treatment of undernutrition 116. milk in the diets of well-nourished children 117. Secular trend of increasing adult height 119. Possible mechanisms for growth-stimulating effects of milk 120. v Dietary dairy and bone health 121. Bone growth 121. Dietary factors that affect bone health 122. milk and dairy foods and bone health 125. Bone-remodelling transient 128. Limitations of studies using bone mineral density as an end point 128. Osteoporosis 128. Calcium-deficiency rickets 131. Summary 132. Dietary dairy and oral health 134. dairy intake, weight gain and obesity development 135.

8 Dietary patterns and the risk of obesity 135. Association between dairy intake and weight status 136. dairy as part of a weight loss strategy 138. dairy intake, metabolic syndrome and type 2 diabetes 139. dairy intake and cardiovascular disease 141. Effects of dietary fat on cardiovascular disease 142. Studies that support reducing animal products and the argument for low-fat versus high-fat dairy products 143. Recent review studies on milk / dairy consumption with respect to cardiovascular disease 146. Other dairy products and risk of cardiovascular disease 151. Summary 152.

9 dairy intake and cancer 154. Colorectal cancer 154. Breast cancer 154. Prostate cancer 155. Bladder cancer 155. Childhood consumption of milk and dairy products and risk of cancer in adulthood 156. Recommendations by the World Cancer Research Fund/American Institute for Cancer Research 156. milk hypersensitivity 158. Lactose intolerance and malabsorption 159. milk -protein allergies 161. Current national recommendations for milk and dairy consumption 162. Conclusion 163. References 164. Annex 183. Chapter 5. dairy components, products and human health 207. Abstract 207. Introduction 207.

10 Vi dairy components 209. milk fat and human health 209. milk protein and health 213. Lactose 216. dairy ingredients 216. dairy products 217. Fermented dairy products 217. Fortified milk and dairy products 219. From traditional to modern dairy foods 221. Regulatory health and nutrition claim framework and recent legislative developments 222. Conclusions 224. References 226. Annex 235. Chapter 6. Safety and quality 243. Abstract 243. Introduction 243. Food-safety hazards specific to milk and milk products 244. Biological hazards 245. Chemical hazards 248. Physical hazards 254.